Merlini E, Cozzi-lepri A, Castagna A, et al. - Despite the effectiveness of cART, increased risk of serious non-AIDS events is still reported among people living with HIV vs the HIV negative population. Researchers herein examined the predictive value of pre-cART inflammation and microbial translocation (MT) for clinical progression in HIV+ patients enrolled in the Icona Foundation Study Cohort. Icona patients with ≥ 2 vials of plasma stored within 6 months before cART initiation and at least one CD4 count after therapy available were included in this study. A total of 486 patients with 125 clinical events were studied: 39 (31%) AIDS, 66 (53%) severe non-AIDS condition (SNAEs) and 20 (16%) deaths. This study yielded some evidence for a correlation between pre-therapy circulating hs-CRP, but not microbial translocation, and higher risk of clinical progression after cART initiation, irrespective of patients’ key confounding factors such as age and nadir CD4 count, in all indicating that pre therapy HIV-driven pro-inflammatory milieu might be a more relevant mediator of long-term HIV-disease progression.